I am a 54 yr old male and had surgery on 09/05/06 for Dupuytren's disease in my left hand.I had let it progress to the point that my little finger was almost completely closed and the 2 next to it were bent about 90 degrees. The surgery was quite extensive and incisions were in the palm and up all 3 fingers in a z cut. As of today, all 3 fingers are still numb and I am experiencing severe burning pain in my hand and fingers.It got to the extent that I could not sleep at night.My surgeon, Victoria Masear, in Birmongham,Al, came highly recommended but she is trying to figure out why I am having so much pain.She has me on Neurontin, a nerve drug, that has helped in numbing the pain but is only a temporary fix. I would like to hear from anyone that has had this similar operation and your recovery period.Thank you and God Bless

In most cases where severe swelling and/or pain results from traditional invasive surgery it is not the surgeon at fault. It is the personal biology of the patient that reacts badly to the invasiveness of Open Surgery of the hand. Furthermore, there is no way to predict who will have this problem and who will not. This is an unfortunate side effect of hand surgery. I would estimate that about 5-10% of patients have sever reactions.

This is true of many invasive procedures as well. This fact is one of the driving forces behind the trend toward less invasive procedure in nearly all areas of surgery. NA is the current surgical option for Dups. The down side is that the less invasive procedures doesn't always get the job done (angioplasty). But, you try them first when indicated and *then* the more invasive.

Your surgery is *far* too recent for you to be concerned for long-term results, and *that* is what counts here. Do all that is asked of you in PT. Pain is not necessarily an indicator of problems after what your hand has been through.

Eight and a half years ago I had surgery for DC on my left (dominant) hand - four fingers involved. Unfortunately, I was one of the apx. 10% to suffer an extreme "flare" with pain, stiffness for more than a year; did not have any professional therapy. However,now my hand is just about perfect- can place all fingers flat on a firm surface - my fingers are slim and straight. Six weeks ago had similar surgery on right hand (let it go about a year too long - good news is that after such extensive surgery DC is less likely to reappear) and same surgeon has recommended professional therapy - I started the day stitches were removed - OUCH! However, now after several sessions of therapy, including forcing my hand into a fist, the ring finger and pinkie are very swollen and - worse - contracting similarly to before surgery (they were straight immediately after.) Therapist believes I have arthritis in the knuckles (am not particularly arthritic - at the age of 76 - that I know of). I am going to refuse the "bending" excercise until these fingers calm down (heat treatments, ultrasound, potassium-chloride, wrapping, wearing a splint - I will tolerate). Doctor (who says that in addition to his notes, after more than eight years and however many patients he REALLY remembers MY hand) believes problem is still a soft tissue one and says my hand is much further long than the left one was.

Does anyone have some thoughts on soft versus aggressive therapy - or development of arthritis?

Some private insurance does cover NA but you just have to check your plan. Mine (a blue cross california plan) covers it but Dr. Denkler is not in their network. So it was covered as an out-of-network item which meant a higher decuctable and a lesser coverage percentage. Still, it was worth doing. I explained to blue cross how much money it saved them over a traditional hand surgery from one of their network providers.